Publix Pharmacy #1422
LBN: Publix Super Markets Inc
Publix Pharmacy #1422 is an health care organization with primary practice located at 620 Virginia Ave N , Tifton GA 31794-4227. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Publix Super Markets Inc can be contacted via phone (229) 386-1171, or through Rusk, Dain via phone (863) 688-1188.
Contact Information
Primary practice address
620 Virginia Ave N
Tifton GA 31794-4227
Phone: (229) 386-1171
Fax: (229) 516-1885
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE009860 | Georgia |
Profile Details
NPI number | 1740535285 |
---|---|
LBN Legal business name | Publix Super Markets Inc |
DBA Doing business as | Publix Pharmacy #1422 |
Authorized official | Rusk, Dain |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Jul 20th, 2012 |
Last updated | Nov 18th, 2019 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1740535285 | NPPES |
Georgia | MEDICAID | 003128633A | |
Georgia | Other | 2136159 |
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